What Everyone With Migraine Should Know About Gut Health

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Key Questions

• What is the gut-brain axis, and how does it influence a person’s potential for migraine?
• Beyond bacteria, what makes up the gut microbiome, and what role does it play in overall body function?
• How does the vagus nerve mediate gut-brain communication, and how is this affected during a migraine attack?
• What interventions, both lifestyle and medical, can support vagal nerve function and gut-brain health?
• What is the oral-gut-brain axis, and how might specific oral bacteria trigger migraine via nitric oxide?
• What are “microbial signatures” in pain disorders, and what typical patterns are observed in migraine?
• Do microbial signatures vary geographically, and what lifestyle factors influence these differences?
• What have studies revealed about the gut microbiome’s influence on the brain and a person’s migraine susceptibility?
• How does the gut microbiome change during a migraine attack?
• Can traumatic events or lifestyle choices negatively impact the gut microbiome?
• Can frequent migraine attacks progressively harm the gut microbiome, and does it have a capacity for recovery?
• What practical dietary and non-dietary steps can be taken to support gut health and potentially reduce migraine?
• How important is increasing fruit and vegetable intake, especially in populations with low consumption?
• Which supplements are useful for supporting the gut-brain connection?
• How can common medications affect the gut and nutrient absorption?
• What acute strategies help manage gastrointestinal issues, like constipation or diarrhea, during a migraine attack?
• What guidance exists regarding microbiome testing versus lifestyle improvements for long-term migraine and gut health?
• How can people with migraine cope with feelings of self-blame or hopelessness regarding migraine management?

Interview Notes

• Robert Bonakdar, MD
• Instagram: DrB_Well_
• Migra Well
• Study: “Oral and gut dysbiosis in migraine: Oral microbial signatures as biomarkers in migraine”
• Study: “The gut microbiome modulates nitroglycerin-induced migraine-related hyperalgesia in mice”
• Study: “Alteration of faecal microbiota balance related to long-term deep meditation”
• Study: “The association between dietary fiber intake and severe headaches or migraine in U.S. adults”
• Study: “Fruit and vegetable intake and odds of pediatric migraine”
• Study: “Adults meeting fruit and vegetable intake recommendations — United States, 2019”
• Clinical trial: “Effects of a multispecies probiotic on migraine headaches”

Treatments Mentioned

• Biofeedback
• CGRP monoclonal antibodies (mAbs)
• CGRP small-molecule receptor antagonists (gepants)
• Deep breathing
• Diet
• Exercise
• Fiber
• gammaCore
• Ginger
• Humming/singing
• Magnesium
• Metformin
• Metoclopramide (Reglan)
• Neuromodulation devices
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Omega-3 fatty acids
• Oral health
• Probiotics
• Proton pump inhibitors (PPIs)
• Riboflavin (vitamin B2)
• Sleep
• Stress management
• Tricyclic antidepressants (TCAs)
• Vagal nerve stimulation
• Vitamin B12

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Disclaimer: The Migraine World Summit aims to bring you a variety of perspectives and expertise, free from bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan. Captions are auto-generated and may contain errors.

Expert

Robert Bonakdar, MD

Pain & Headache Specialist
Scripps Center for Integrative Medicine